Abstract: Objective To explore the effects of impaired fasting glucose(IFG) and gestational weight gain(GWG) of the elderly pregnant women with gestational diabetes mellitus(GDM) on neonatal birth weight. Method A total of 853 elderly pregnant women(EPW) were recruited into this retrospective survey study from 1^st January 2017 to 31^st December 2017. The IFG status and GWG level were used as stratified factors and the difference of the delivery rate of newborns with abnormal birth weight was compared by the stratified factors.Results The birth rates of macrosomia(MS) and large for gestational-age(LGA) neonates from EPW with IFG status were significantly higher than those of EPW with non-IFG status(7.6% vs. 3.4% for MS and 19.0% vs. 8.2% for LGA,respectively,P<0.05). The birth rates of small for gestational-age(SGA) and low birth weight(LBW) neonates from EPW with GWG <10 Kg was the highest(9.19% and 8.65%,respectively,P<0.05) while the MS and LGA neonates from EPW with GWG≥15 kg group was the highest(10.14% and 19.53%,respectively,P<0.05). Moreover,the LGA rate was highest among EPW with GWG≥15 kg and IFG(29. 2%,P<0.05). The LBW rate was highest among EPW with IFG and GWG <10 kg(10.0%,P=0.0399). And the SGA rate was highest among EPW without IFG and with GWG <10 kg(10.4%,P=0.0137).Conclusion The level of GWG and IFG status among EPW with GDM may affect the occurrence of birth weight and they may interact with each other.